Association of beta-blockers and first-registered heart rhythm in out-of-hospital cardiac arrest: Real-world data from population-based cohorts across two European countries
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Association of beta-blockers and first-registered heart rhythm in out-of-hospital cardiac arrest : Real-world data from population-based cohorts across two European countries. / Barcella, Carlo A.; Eroglu, Talip E.; Hulleman, Michiel; Granfeldt, Asger; Souverein, Patrick C.; Mohr, Grimur H.; Koster, Rudolph W.; Wissenberg, Mads; de Boer, Anthonius; Torp-Pedersen, Christian; Folke, Fredrik; Blom, Marieke T.; Gislason, Gunnar H.; Tan, Hanno L.; ESCAPE-NET Investigators.
I: Europace, Bind 22, Nr. 8, 2020, s. 1206-1215.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Association of beta-blockers and first-registered heart rhythm in out-of-hospital cardiac arrest
T2 - Real-world data from population-based cohorts across two European countries
AU - Barcella, Carlo A.
AU - Eroglu, Talip E.
AU - Hulleman, Michiel
AU - Granfeldt, Asger
AU - Souverein, Patrick C.
AU - Mohr, Grimur H.
AU - Koster, Rudolph W.
AU - Wissenberg, Mads
AU - de Boer, Anthonius
AU - Torp-Pedersen, Christian
AU - Folke, Fredrik
AU - Blom, Marieke T.
AU - Gislason, Gunnar H.
AU - Tan, Hanno L.
AU - ESCAPE-NET Investigators
PY - 2020
Y1 - 2020
N2 - Aims: Conflicting results have been reported regarding the effect of beta-blockers on first-registered heart rhythm in out-of-hospital cardiac arrest (OHCA). We aimed to establish whether the use of beta-blockers influences first-registered rhythm in OHCA. Methods and results: We included patients with OHCA of presumed cardiac cause from two large independent OHCA-registries from Denmark and the Netherlands. Beta-blocker use was defined as exposure to either non-selective beta-blockers, b1-selective beta-blockers, or a-b-dual-receptor blockers within 90 days prior to OHCA. We calculated odds ratios (ORs) for the association of beta-blockers with first-registered heart rhythm using multivariable logistic regression. We identified 23 834 OHCA-patients in Denmark and 1584 in the Netherlands: 7022 (29.5%) and 519 (32.8%) were treated with beta-blockers, respectively. Use of non-selective beta-blockers, but not b1-selective blockers, was more often associated with non-shockable rhythm than no use of beta-blockers [Denmark: OR 1.93, 95% confidence interval (CI) 1.48-2.52; the Netherlands: OR 2.52, 95% CI 1.15-5.49]. Non-selective beta-blocker use was associated with higher proportion of pulseless electrical activity (PEA) than of shockable rhythm (OR 2.38, 95% CI 1.01-5.65); the association with asystole was of similar magnitude, although not statistically significant compared with shockable rhythm (OR 2.34, 95% CI 0.89-6.18; data on PEA and asystole were only available in the Netherlands). Use of a-b-dual-receptor blockers was significantly associated with non-shockable rhythm in Denmark (OR 1.21; 95% CI 1.03-1.42) and not significantly in the Netherlands (OR 1.37; 95% CI 0.61-3.07). Conclusion: Non-selective beta-blockers, but not b1-selective beta-blockers, are associated with non-shockable rhythm in OHCA.
AB - Aims: Conflicting results have been reported regarding the effect of beta-blockers on first-registered heart rhythm in out-of-hospital cardiac arrest (OHCA). We aimed to establish whether the use of beta-blockers influences first-registered rhythm in OHCA. Methods and results: We included patients with OHCA of presumed cardiac cause from two large independent OHCA-registries from Denmark and the Netherlands. Beta-blocker use was defined as exposure to either non-selective beta-blockers, b1-selective beta-blockers, or a-b-dual-receptor blockers within 90 days prior to OHCA. We calculated odds ratios (ORs) for the association of beta-blockers with first-registered heart rhythm using multivariable logistic regression. We identified 23 834 OHCA-patients in Denmark and 1584 in the Netherlands: 7022 (29.5%) and 519 (32.8%) were treated with beta-blockers, respectively. Use of non-selective beta-blockers, but not b1-selective blockers, was more often associated with non-shockable rhythm than no use of beta-blockers [Denmark: OR 1.93, 95% confidence interval (CI) 1.48-2.52; the Netherlands: OR 2.52, 95% CI 1.15-5.49]. Non-selective beta-blocker use was associated with higher proportion of pulseless electrical activity (PEA) than of shockable rhythm (OR 2.38, 95% CI 1.01-5.65); the association with asystole was of similar magnitude, although not statistically significant compared with shockable rhythm (OR 2.34, 95% CI 0.89-6.18; data on PEA and asystole were only available in the Netherlands). Use of a-b-dual-receptor blockers was significantly associated with non-shockable rhythm in Denmark (OR 1.21; 95% CI 1.03-1.42) and not significantly in the Netherlands (OR 1.37; 95% CI 0.61-3.07). Conclusion: Non-selective beta-blockers, but not b1-selective beta-blockers, are associated with non-shockable rhythm in OHCA.
KW - Asystole
KW - Beta-blockers
KW - ESCAPE-NET
KW - First-registered heart rhythm
KW - Non-shockable heart rhythm
KW - Out-of-hospital cardiac arrest
KW - Pulseless electrical activity
U2 - 10.1093/europace/euaa124
DO - 10.1093/europace/euaa124
M3 - Journal article
C2 - 32594166
AN - SCOPUS:85089128042
VL - 22
SP - 1206
EP - 1215
JO - Europace
JF - Europace
SN - 1099-5129
IS - 8
ER -
ID: 258329484